Electromagnetic Navigation in Distal Locking of Long Diaphyseal Interlocking Intramedullary Nailing

Objective: To describe the applications and effects of electromagnetic navigation (EN) technology in distal locking for the treatment of long diaphyseal fracture (LDF) with interlocking intramedullary nailing (IIN). Study Design: An interventional study. Place and Duration of Study: The Second Affiliated Hospital of Soochow University, China, from March 2013 to July 2014. Methodology: Patients who underwent IIN-LDF were selected. Twenty-four (50%) of whom were operated under EN guidance (group A) and the other 24 (50%) under conventional targeting guidance (group B). The distal locking time and X-ray irradiation time of the two groups were compared. Results: Each group included 16 (33.3%) cases of femoral fracture and 8 (16.7%) cases of tibial fracture. The success rate of distal locking in group A was higher than that in group B (95.8% vs. 83.3%, p=0.045). There were statistically significant differences in the distal locking time and X-ray irradiation time of femoral intramedullary nailing between the two groups (p=0.027 and p=0.001, respectively). There were no statistically significant differences in the distal locking time and X-ray irradiation time of tibial intramedullary nailing between the two groups (p=0.347 and p=0.056, respectively). Conclusion: EN-IN was advantageous as it enabled easy targeting, significantly reduced intraoperative fluoroscopy and operation time and small trauma and had other advantages when used for treating LDFs, especially femoral diaphyseal fractures.